AGENDA FOR CHANGE
NHS JOB EVALUATION SCHEME
JOB DESCRIPTION
1. JOB IDENTIFICATION
Job Title: Advanced Nurse -Teenage Cancer Trust Teenage & Young Adult CancerReports to: Consultant Nurse – Cancer Care
Department, Ward or Section: Cancer Services
Operational Unit/ Corporate Department: Inner Moray Firth Operational Unit, Raigmore Hospital
Job Code: SSCANCRAIGNURS02
No of Job Holders: 1
Date: February 2017 (FV March 2017)
2. JOB PURPOSE
· To take a lead role operationally, clinically and strategically, working with multi- professional teams across the nominated geographical region to develop excellence in Teenage and Young Adult Cancer care.· To work closely with the Teenage Cancer Trust & MSN CYPC National Lead Nurse to develop excellence and best practice in Teenage & Young Adult cancer services across the geographic area and in Scotland, within the context of National recommendations and best practice guidance.
· Work autonomously, demonstrating a high level of clinical expertise when identifying and caring for the specific needs of Teenagers and Young Adults with cancer and their families.
· To act as the key worker for Teenagers and Young Adult cancer patients where there is a requirement, ensuring specialist assessment of need.
· Act as a role model demonstrating high standards of care and providing clinical leadership in Teenage and Young Adult Cancer care to other members of the multi professional team specific teams.
· Provide specialist Teenage and Young Adult cancer education and resource to the multi professional teams.
· The postholder will at all times promote the philosophy of the Teenage Cancer Trust charity.
3. DIMENSIONS
Each year in Scotland there are approximately 200 new cases of cancer diagnosed in teenagers and young adults age 16 – 24 years (ISD 2015). Although there have been improvements in survival, cancer in this age group remains a significant problem with survival in teenagers and young adults significantly lower than in children for several tumour types with factors relating to delays in diagnosis and low levels of clinical trial participation linked to some of the differences (CRUK 2015).
Teenagers and Young Adults with cancer have complex and specialised needs related to their stage of development and disease which requires a different model of care to that of children and older adults, one which provides the advantages of an age appropriate environment and support network, where young people benefit from the expertise of both cancer-site specific and Teenage and Young Adult teams. However, Teenage and Young Adult cancer care is a small speciality within healthcare which has rarely been seen as a priority. Despite the development of an evidence base which exists for the treatment of this group and worldwide recognition that this distinctive group of patients have complex and specialist needs related not only to their disease, but to their developmental age (Zebrack et al 2010; NICE 2005), there remains gaps in the service provision required to meet their needs (Teenage Cancer Trust 2012b). Working with the NHS, Teenage Cancer Trust has established the new specialism of Teenage and Young Adult cancer care in the UK. However despite the positive impact of Teenage Cancer Trust’s work it is estimated that only fifty percent of young people are able to access specialist care in the UK (Teenage Cancer Trust 2015).
In Scotland, a Managed Service Network for Children and Young People’s cancers (MSN CYPC) has been established; its aim is to attain the best possible outcomes for children, teenagers and young adults with a cancer diagnosis. The MSN CYPC Cancer Plan for Children and Young People in Scotland (MSN CYPC 2016) sets out an objective for all young patients with cancer to receive the right diagnosis and be treated with the right treatment, by the right team in the right place on their cancer journey. An important factor in delivery of this objective is setting standards of care which will deliver the very best clinical outcomes. In order to achieve these improvements in care for teenagers and young people, the Cancer Plan acknowledges that a new model of care will be required (MSN CYPC 2016). A model, which in addition to several key areas such as improvements in clinical trial access and discussion at a TYA Multidisciplinary Team Meeting, also includes the right for young people regardless of where they live in Scotland to have equitable access to age appropriate cancer care and support from time of first diagnosis (MSN CYPC 2016).
The role of the Teenage Cancer Trust TYA cancer Advanced Nurse will be to provide Teenagers and Young Adults and their families with age appropriate clinical expertise and support to meet the specialist care needs related to the young person’s stage of development and disease. The postholder will work with the National Lead Nurse for TYA cancer and the multi professional cancer site specific teams to develop a model of care for Teenagers and Young Adults with cancer to improve clinical outcomes and patient experience. The postholder will work with the MSN CYPC National TYA MDM (multi-disciplinary team meeting), ensuring young people benefit from a holistic approach to care, including rehabilitation, enablement and psychosocial support.
The postholder will be expected to work autonomously and to demonstrate a high level of initiative, adaptability, planning ability, sound judgement and competent analysis and evaluation skills. The role will require clinical expertise in Teenage and Young Adult cancer, effective negotiation, influencing and leadership.
4. ORGANISATIONAL POSITION
5. ROLE OF DEPARTMENT OR SECTION
The role of Teenage & Young Adult Cancer services in Highlands will be to further develop care, services & personnel in relation to the management of young people with cancer. Within cancer services there are approximately 10 TYA diagnosed with cancer each year, however the services will include those children who were treated for cancer before the age of 16 if it is appropriate for them to transition into adult care. The service will establish pathways of care, promote self management, minimise disease related complications allowing the young person to continue with their lives with minimal impact.The aim of the service is to provide a specialist cancer service for patients, their families and members of the multi-professional team within both the acute and community care setting by promoting and managing the complexities in the symptomatic and psycho-social wellbeing of patients and their families/carers
As an integral part of the multi-professional team the aim is to also influence clinical practice, and to provide a consultative, leadership and educational role to professional colleagues. The postholder acts at all times within the requirements of the NMC’s code of professional conduct and NHS Highland policies & procedures.
6. MAIN TASKS, DUTIES AND RESPONSIBILITIES
Advanced Clinical Practice· Provide comprehensive highly specialist, clinical care, support and advice to teenagers and young adults (TYA) with cancer across service boundaries and along the cancer pathway.
· Work collaboratively to ensure continuity and coordination of care by actively interfacing between patients, cancer site specific teams, primary and tertiary care.
· Put quality at the heart of practice by delivering evidence based individualised and personalised care through a TYA holistic needs assessment, planning and evaluation of care.
· Assesses, plan, implement and evaluate care and treatment using specialist knowledge and skills.
· Practice autonomously, organising own clinical workload.
· Undertake clinical procedures where dexterity and accuracy are required.
· Maintain a safe working environment.
· Provide comprehensive patient core contact for the TYA Service through media available to the patient e.g. face to face, text, telephone, home visit (if necessary), website, e-mails, written information.
· Where required assume the role of Key Worker to patients (aged16-24) who do not have a Clinical Nurse Specialist or Key Worker already in place.
· Develop relationships and pathways that enable appropriate referral of TYAs to other professionals for more specialist support, for example, Palliative Care Consultant, clinical psychologists, social worker, youth support coordinator etc.
· Act as an expert resource and role model by advising on the management of TYA patients and their specialist needs to clinical and support staff within the designated geographic area.
· Demonstrate critical thinking and diagnostic reasoning skills in clinical decision making.
· Demonstrate a high level of autonomy and decision making skills regarding nursing assessment, care interventions, referral and service provision.
· Discuss diagnosis and potential treatment options with TYA, their families and carers, in depth and with sensitivity, knowledge and compassion while respecting patient confidentiality and privacy.
· Act as an advocate for TYA with cancer when appropriate, and ensure informed and educated consent is given for treatment and in clinical trial participation.
· Promote TYA patient entry into age appropriate and disease appropriate clinical trials.
· Facilitate the transition of teenagers and young adults from children’s cancer services to adult cancer services by building collaborative relationships with paediatric and adult cancer services to develop a transition pathway.
· Work in close collaboration with the National TYA MDM coordinator and cancer site specific teams to ensure that all newly diagnosed TYA patients are discussed at the National TYA MDM.
· Attend the National TYA MDM, contributing to multidisciplinary discussion and assessment of TYA holistic needs.
· Maintain accurate clinical and other records using the NHS Trust’s documentation.
Professional Leadership
· Demonstrate expert clinical leadership skills, which promote the delivery of excellent clinical practice and high quality effective service delivery to teenagers, young adults and their families.
· Contribute to the development of local, regional and National policy and guidance on TYA cancer care by leading and promoting collaboration across organisational boundaries, through building trust, developing shared values and effective multidisciplinary education and communication.
· Seek opportunities to influence local, regional and National policy development and strategic change which meets the needs of teenagers and young adults and their families.
· Manage resources effectively and influence strategic delivery of services within the required resources.
· Promote a culture that supports self-management in teenagers and young adults with cancer.
· Provide specialist education and training to other professionals involved in the care of teenagers and young adults with cancer.
· Embed patient and public involvement within the sphere of teenage and young adult cancer practice.
· Collate and record quantitative and qualitative data to provide evidence of productivity, outcomes and quality, through audit and research.
· Identify key requirements needed to carry out the specialist role and manage the service.
· Contribute to the delivery of Teenage Cancer Trust Nursing and Outcomes and delivery of an Annual report to the Charity.
· Contribute to the implementation of the strategic Teenage Cancer Trust Nursing Strategy.
· Demonstrate skills in conflict resolution and competent negotiation skills when dealing with difficult or challenging situations.
Education
· Develop, deliver and facilitate practice-based education programmes to assist in the delivery of sustainable models of care and facilities for teenagers and young adults with cancer.
· Work with the National TYA Lead Nurse and the wider teenage and young adult cancer community to contribute to the delivery of local and national education programmes for multi-professional staff that have direct or indirect contact with TYAs with cancer.
· Assess and meet the information needs of teenagers and young adults and their families.
· Attend national, regional and local conferences as appropriate and disseminate information to the team.
· Provide formal/informal clinical supervision to colleagues.
· Attend Teenage Cancer Trust events and meetings as requested and agreed with the Charity.
· Attend national education programmes/meetings on behalf of Teenage Cancer Trust.
Practice and Service Development, Research and Evaluation
· Disseminate and share best practice at a local, national, UK and international level.
· Utilise up to date research/evidence to deliver specialist TYA cancer patient care.
· Work in partnership with the multi-professional team to identify and implement agreed evidence-based practice and achieve optimal decisions for overall patient care.
· Contribute and participate in TYA cancer research agenda.
· Regularly undertake and or lead service audit to evaluate standards of care for teenagers and young adults with cancer and ensure continuous improvement of patient care.
Professional Development
· Take personal responsibility for life-long learning and personal development through appraisal and Knowledge and Skills Framework.
· Actively participate in own personal development plan and performance review.
· Actively participate in the host / employing organisations appraisal process with Teenage Cancer Trust Lead Nurse contribution to this process as appropriate, in line with Teenage Cancer Trust Nursing objectives and strategy.
· Contribute at a local, national and international level to promote TYA cancer care.
· Take personal responsibility for attendance at mandatory/ statutory training and updating as per NHS host board statutory and mandatory training requirements and inform your manager if there is any deviance from training attendance at mandated intervals.
· Maintain a high standard of personal behaviour and ensure effective communication with all members of the multidisciplinary team, patients carers and relatives.
· Provide and accept constructive feedback and use this to reflect on your own practice.
· Recognise the limits of individual competence and knowledge, undertake further training and academic qualifications as relevant to the role and service requirements
· Act at all times within the sphere of the Nursing and Midwifery Council Code of Professional Conduct, and other relevant national guidelines.
· Continually work towards revalidation and actively identify opportunities that would evidence towards this process.
· Adhere to NHS Board policies and protocols.
· Act as a professional resource to colleagues.
· Receive and engage in clinical supervision sessions
· Write an annual report related to the service, circulating and presenting appropriately.
· Recognise signs of stress in self and the emotional impact of care in self and others and take appropriate action. Be proactive in the recognition and management where this may manifest on personal performance and take steps to address this where required.